Welcome to the NHSCFA’s Annual Reports and Accounts for 2025 to 2026. Our target for 2023 to 2026 was to realise financial values of fraud detected, prevented, and recovered to a value of £500 million, which we have surpassed, achieving in excess of £590 million. As we reflect, I’d like to highlight all the NHSCFA’s efforts that enabled us to surpass our financial targets and the impact of counter fraud work, reflecting both our cumulative performance against strategic targets and our achievements during this reporting year.
Our performance in 2025 to 2026 has been assessed against a clear set of key performance indicators, providing a strong foundation for strategic improvement and supporting evidence-based decision making for the year ahead.
Our stakeholders have played a critical role in this success. At our Local Counter Fraud Specialist (LCFS) conference in January, we brought colleagues together to explore current fraud risks, consider future challenges, and identify opportunities for deeper collaboration. Engagement of this kind is vital in strengthening our collective resilience and supporting fraud prevention across the community.
Collaboration with LCFSs has continued to mature, building closer relationships that have enabled faster intelligence sharing and more efficient case progression. This has, in turn, supported the delivery of additional community workshops, the launch of strategic tools such as the Enterprise Fraud Risk Assessment (EFRA), and the development of a dedicated horizon scanning function.
These achievements are a direct reflection of the commitment and professionalism of our staff and partners across the counter fraud community. I would like to extend my sincere thanks for their contribution over the past year and for their continued support in the year ahead.
Moving forward for next year our new NHSCFA strategy, which will be aligned to the NHS 10 Year Plan and the DHSC Counter Fraud Strategy, will be underpinned by a new a new delivery model. The focus will be on prevention and recovery along with a stronger stewardship role for the organisation, including collating performance and activity, assuring against standards, and scaling up controls that work so they are replicated across the system.
We will be placing ‘Counter Fraud by Design’ at the core of our approach, aligning with the direction of NHS reform. This sets the foundation for a longer-term ambition in which counter fraud is fully embedded within frontline services, protecting health resources from fraud while supporting service delivery and modernisation.
We opened a formal consultation on the proposed advanced data analytics function of Project Athena which outlined proposed changes to how the CFA organises its analytical, data science, data engineering and data acquisition capabilities. The programme has strengthened the CFA’s data and analytical capability, providing the foundation for advanced, data-driven counter-fraud work.
The CFA launched Project WISE this year (Workforce Integrity and System Efficiency) - a first of its kind, proactive, data-driven initiative designed as a strategic response to fraud risks within the NHS. This represents a proactive approach to tackling NHS fraud head-on. The project will:
- analyse both local and national datasets
- generate intelligence from data outliers
- support local counter fraud teams through NHSCFA expertise and resources
- assess return on investment to inform a potential national adoption
International Fraud Awareness Week (IFAW) formed a key part of strengthening our focus on organisational learning and supporting the NHS to better understand and prevent financial loss to fraud. We reached 1.9 million NHS staff, along with international partners and the wider counter fraud community, to share insights and strengthen our collective understanding of global fraud risks in health with our downloadable materials and campaign.
Our ongoing and past investigations highlight the vigilance and dedication of our investigators and shows that we continue to ensure that those who seek to exploit the health service for their own benefit are identified and brought to justice. Highlights of the past year’s cases include:
- a former NHS resident doctor being sentenced to three years’ imprisonment after defrauding the NHS out of more than £268,000
- a conviction of a former NHS credit controller for fraud by abuse of position and money laundering resulting in five convictions in a £300k case
- a confiscation order that forced a former NHS manager to return £175,000 that they defrauded from the NHS defrauding a former Clinical Commissioning Group out of £564,484
Without our investigators, these offenders would have gone unpunished, and our work ensures that such abuses are identified and prosecuted, protecting NHS funds for patient care.
I’d like to thank our Chair, Dame Linda Pollard, and Interim Chair, Gaon Hart, for all their hard work the past year guiding us through our transformation period and helping to achieve our aspirations to remain an independent organisation.
The organisation and I have benefited from their direction and experience. I’m also delighted to be working with our new Chair, Tom Hayhoe, who brings a wealth of expertise to the CFA, such as in his previous role such as Chair of West London Mental Health NHS Trust (renamed West London NHS Trust in 2018), Investigating Committee Chair on the Nursing and Midwifery Council’s Fitness to Practise Panel, and up until the end of 2025, Covid Counter-Fraud Commissioner.
The value we make as an arm’s length body with our expertise and commitment to counter fraud cannot be understated. Let us continue to build on these achievements over the next year and beyond.
Alex Rothwell
Chief Executive Officer